kevro1013

We had a pt come in in status asthmaticus tonight. After her her hour long nebs and solumedrol ivp, she wasnt much better (RR=32 sat93% on RA). The ER MD ordered Mag sulfate 2 grams iv over 30 minutes. I had never heard of that as a treatment for AE ...

Great thread! Here is one I had last week. Pt pressents with abd pain and htn (BP 230/120). Non-contrast Ct abd and pelvis shows non-disecting AAA. MD orders nipride to titrate for BP >160/90. What type of medication does this pt need prior to ni...

I once took care of a guy who accidently shot himself in the right upper leg with a .25 pistol. He was in Babies 'R' Us buying his newborn grandson a carseat. When he reached into his pocket to get exact change at the register, he pulled the trigge...

If you attempt suicide by taking 200 assorted pills in front of your parole officer and you are brought to the ed to get lavaged, the sorbitol in the charcoal might give you explosive diarrhea. If this happens and you find yourself incontinent of sto...

Anyone else use fentanyl in the ED for acute pain? We currently use it for most cons. sedations (with versed). We have a Doc that orders it a lot for acute pain with an order like: Fent. 50-100mcg iv q 20 min prn. Most pts with this type of order ar...

A nurse in our ER got written up by an ICU nurse because she did not weigh a pt before starting them on heparin. The pt was having an acute MI! The pt guestimated his weight @ 95kg, when they weighed him on the bed in the CCU he weighed 96.5kg. Our E...

Actually, Bilateral BPs are a good idea when assessing for a AAA, greater than 20mm hg difference can be a significant finding.

Heard the MD tonight order Dopamine as "no hopeamine" (I guess he didnt want to "leave em dead" with levophed)

WOW! Really puts a new twist on pushing someone's buttons!

You have been preparing to take the nclex since you took your first nursing exam in school (thats what instructors try to model questions after). I agree with the above posts; if you have been reviewing the material and are doing well on practice tes...

Great post! I must be a combo tool belt/joker (striving to be a good guy) would like to add: "The grass is greener nurse"- Sometimes an agency nurse sometimes not, always has a negative comment about this facility ie: "we never have hall patients @...

It sounds like your facility is already ahead of the game! I must say though one of the most challenging type of pt in the ER from LTC is a chief complaint of altered mental status with no base line to compare to and also when the symptoms were notic...

Do not take left over medications out of the sharps boxes and mix them together and shoot them up in the employee bathroom of the ER you happen to work in. SOME of those medications MIGHT contain sedatives and vasoactives that MIGHT make your heart ...

-This would categorize as one of the sickest things I've ever seen. This IV drug user had been shooting in the dorsal vein of his penis (I'm not kidding). It had abcessed and swollen almost to the point that distal circulation was being compromise...

In our ED a nurse that had been an ED nurse for 45 years used to say 0 is no pain 10 is acid in your face....

DNAR=do not attempt resuscitation; if the pt has a decline in condition do they not deserve medical treatment? DNR means not to "code" them- Withdrawling medical care totally from someone to let them die is hospice care* I agree if a pt is in LTC and...

This is a very sensitve issue. Just my two measly cents. Did the Physician discuss these aspects of your care to you as well or only to your father in private? I understand you were in a great deal of pain and were to be medicated with narcs (both ...

We have had many flooding our ED with "Flu" like symptoms: fever, cough, chills etc.. Many do not even take tylenol/advil at home for the fever-they just come in and c/o fever. I am trying to take the opportunity to educate about this (take tylenol...

FTD= fixing to die Microdeckia=not playing with a full deck Chartomegaly=chart so big it can't fit in the tube PID=pus in 'dere OB/GYN=oh boy-got ya naked! (by the way I love the cbt=chronic biscuit toxicity)

In the facility where I work, NONE of the 4 units have a room 13. (12 then 14) However I work in the ED where in room 13 I had a spell over one month where we put in 4 ventriculostomies! (we maybe see one every other month) I can also remember most o...

Emtala requires that a pt receive a medical screening exam and receive appropriate treatment to be stabilized and rule out any emergency situation. Since the pt was discharged by the MD, the report to the receiving facility was a courtesy. At our ED...

Ditto to scis, also sounds like your triage area needs another RN- I know it gets harry out there- sounds like you need a break from triage- I know I do once in a while!

I had a sweet lol (little old lady) once who had a pca pump and she kept dropping her administration button. When I went in to find it for her she said Where is my "SPICER UPPER"? Right here tied to you sweetie...

Craig, Thanks for all of your insights, they have been entertaining, informative and inspiring. You are like that upperclassman in Nursing school who always told you what it will be like "next semester", what to expect, who to watch out for, and mos...